Evolution of gastrointestinal double contrast radiography in China: researches, application and popularization

Figure 1 Diagramatic drawing shows the different menifestations in protrusion (blurring in outer side) and in depression (blurring in inner side) caused by barium collection in recesses.

Figure 2 Model DC. The larger round images are protrusions and the smaller ones are depressions. They are all located on Ad wall in A and in Ab wall in B. Note the difference in protrusion (blurring in outer) and in depression (blurring in inner); and the difference of the same lesion in Ad wall (A) or in Ab wall in B.

Figure 3 Gastric specimen magnified (× 10) with a biomicroscopy shows the substructures of AG.

Figure 4 Area gastrica in clinical DC shows silkworm-like AG, petal-like AG and the step-over lines of two overlapping walls.

Figure 5 DC of human gastric specimen shows the subtle difference of AG in two overlapping walls (upper 1/3 part) and single unoverlapping wall (lower 2/3 part).

Figure 6 Diagramatic representation of AG. W, silkworm-like AG; SA, sub-AG; SV, subgrooves.

Figure 7 Diagram depicts the step-over lines of AG in two overlapping walls seen in DC film.

Figure 8 Gastric specimen with barium coated and radiographed by soft X-ray showing the ulcer crater and the grooves of AG surounding it.

Figure 9 The same sized small round protruions located in Ads wall. Note the different appearance in various phase of “tide and rock”. Those are most distinctable in “low water tide” (arrow).

Figure 10 A patient with 6 polyps in gastric antrum. In Fig 10, 3 polyps in Ab wall (anterior wall) appeared as eye-like sign (single arrow), one in lateral wall apeared as bowler hat sign (double arrows). In Figure 11, the 3 polyps in Ab wall and 3 in Ad wall (single arrow) all can be seen in horizontal projection.

Figure 11 A patient with 6 polyps in gastric antrum. In Fig 10, 3 polyps in Ab wall (anterior wall) appeared as eye-like sign (single arrow), one in lateral wall apeared as bowler hat sign (double arrows). In Figure 11, the 3 polyps in Ab wall and 3 in Ad wall (single arrow) all can be seen in horizontal projection.

Figure 12 Two patients with gastric carcinoma located in lessor curvature involving Ab wall. Both cases in DC appeared as multiple mural lines sign and foggy droplets sign.

Figure 13 Two patients with gastric carcinoma located in lessor curvature involving Ab wall. Both cases in DC appeared as multiple mural lines sign and foggy droplets sign.

Figure 14 Sigmoid colon carcinoma appeared as foggy droplets sign.

Figure 15 Localized carcinoma of sigmoid colon, two projections in the same case, showing the multiple mural lines sign (double arrows) and the foggy droplets sign (single arrow). Figure 16 the multiple mural lines sign (double arrows) and overlapping white lines (single arrow).

Figure 16 Localized carcinoma of sigmoid colon, two projections in the same case, showing the multiple mural lines sign (double arrows) and the foggy droplets sign (single arrow). Figure 16 the multiple mural lines sign (double arrows) and overlapping white lines (single arrow).

Figure 17 Model DC, demonstrating the mechanism of multiple mural lines sign. The “infiltration” of the lat-eral upper wall of the sac made the part of the wall less expansion (right upper picture, horizontal projection) and appeared as multiple lines of rigidifying, roughing and “whiter” in image density in other 3 pictures taken in perpendicular projection.

Figure 18 Diagramatic drawing demonstrates the mechanism of multiple mural lines sign on horizontal projection (A) and its appearance on perpendicular projection (B). (A, Horizontal projection; B, perpendicular projection.)

Figure 19 Diagram of foggy droplets sign. More BS have been stagnated on the irregular surface of Ab wall carcinoma (A) and “foggy doplets” appearance was formed (B). (A, Horizontal projection; B, perpendicular projection.)